Clinical Research Of Three-coeliac Tube Internal Drainage Combined Extraperitoneal Drainage To Prevent Low Rectal Cancer Anastomotic Fistula

Rectal carcinoma is one of the most common malignant gastrointestinal tumors,its mortality only interior to gastric carcinoma,it's an important part of colorectal carcinoma.As people change eating habits and lifestyle,its incidence is increasing rapidly.Low rectal carcinoma occurs under peritoneal reflexa,accounts for about 70% of all colorectal carcinoma.As the idea of total mesorectal excision(TME)are extended in recent years,and the progress in operation skills?the popularity of surgical instruments?the application of neoadjuvant chemoradiation,the probability of anus reservation in low rectal cancer has been lifted markedly,but the anastomotic leakage rate increased.Postoperative anastomotic fistula is one of the serious complications,the incidence ranged from 0.6%-17.4% according to reported,precautions include:1)sufficient preoperative preparation and treat anemia,improve nutritional status,enhance the tolerance of patients to operation;2)completely cleanse the intestines prior to surgery,adequate anal dilatation before the anastomosis,and washed with sterile normal saline to reduce the concentration of bacteria.3)esuring the blood supply of anastomotic location and reducing the tension of anastomotic location while still following the TME guidelines.4)drain tube is placed in pelvic low to reduce pelvic fluid.5)anal tube was placed during operation used for drainage of intestinal content and gas,reduce intestinal and anastomotic pressure.6)adequate nutrition support is provided after surgery,using sufficient and effective antibiotics to prevent infection.7)prophylactic ileostomy and colostomy to reduce the severity and occurrence of anastomotic fistula,reduce the incidence rate of anastomotic inflammation?pelvic infection and general peritonitis,improve the successful rate.We compared with the conventional abdominal drains,to evaluate furtherthree-coeliac tube drainage in the lumen combined with extraperitoneal drainage for preventing anastomotic leakage,to explore a new noninvasive way for preventing and treating anastomotic leakage.Objective: to evaluate further three-coeliac tube drainage in the lumen combined with extraperitoneal drainage for preventing anastomotic leakageMethods: the clinical data of 221 patients with low anterior resection of rectal cancer was analyzed from January 2010 to March 2015 in Department of General Surgery,3rd Affiliated Hospital,He Bei North University,randomly divided into experimental group and control group,128 cases adopted three-coeliac tube drainage in the lumen combined with extraperitoneal drainage,93 cases adopted the conventional abdominal drains,to summarize and analyze the operation time?the postoperative fistula incidence and the rates of second surgical intervention.Results: there were significant differences in rates of fistula incidence and second surgical intervention compared with control group,but no significant difference in operation time and defecating time,no severe complication was occurred in both groups.Conclusion: three-coeliac tube drainage in the lumen combined with extraperitoneal drainage could reduce the incidence of anastomotic fistula,improve the cure rate,reduce the rate of second surgical intervention and improve the patients quality of life.